Many of us occasionally suffer from social anxiety, which can manifest as butterflies in our stomachs before a job presentation or as uneasiness before a cocktail party. It’s common to have feelings of shyness, trepidation, or anxiety when we find ourselves in unfamiliar situations. However, if your social anxiety becomes severe and starts to interfere with your day-to-day activities, it may be a sign of a common problem known as social anxiety disorder.
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What is social anxiety disorder?
Anxiety disorders such as social anxiety disorder (SAD), often known as social phobia, are prevalent mental health conditions that impact as many as 7% of adult Americans annually. An intense anxiety of social situations, such as giving speeches or performances or going to parties, is a defining feature of SAD. SAD sufferers worry that other people will judge them and make fun of them. Those who experience this dread may find it extremely distressing and unable to pursue their goals.
Social anxiety disorder symptoms
The primary sign of social anxiety disorder is an intense fear of other people’s scrutiny or embarrassment. A person who experiences extreme fear may completely avoid social situations.
Along with the fear, anxiety can also cause physical problems. As an illustration:
- sweating a lot
- blushing
- heart palpating quickly
- nausea
- feeling out of breath
- trembling
Social anxiety disorder comes in two flavors. The majority of SAD sufferers experience generalized social anxiety, which makes them fearful of social gatherings like parties and meetings. Social anxiety in SAD sufferers typically first experiences it in their early or adolescent years. Usually, symptoms worsen with time. Symptoms of social anxiety disorder are more severe and persistent than those of ordinary anxiety. Relationships, careers, daily routines, and general quality of life begin to suffer as a result of this stress.
Performance-only social anxiety is a somewhat less common kind of SAD. Only moments when they are the center of attention, like giving a speech or performing, are frightening to people who suffer from performance anxiety. Unlike generalized social anxiety, which manifests later in life, performance anxiety is less debilitating.
Causes and risk factors
It is believed that biological and environmental factors—the effects of both nature and nurture—are the causes of social anxiety disorder. Researchers think that a complicated interplay between neurological (what’s happening in the brain and nervous system) and psychosocial (the impact of life events, thoughts, and actions) elements leads to the development of SAD.
Brain and neurological system-related causes of SAD include:
- An overactive neurological system. This implies that the body can release the stress hormone cortisol in response to even minor emotional stimuli.
- Reduced levels of the hormone serotonin in the brain, which regulates mood.
- Aberrant oxytocin and glutamate levels in the brain. These hormones regulate social response and the severity of anxiety symptoms.
- Enhanced sensitivity in the brain regions responsible for mood and emotion regulation.
Early childhood trauma, such as a history of abuse and neglect, and childhood teasing are psychosocial causes of social anxiety disorder (SAD). Additionally linked to the condition are overly critical and protective parenting approaches. These experiences have an impact on your social interactions and reaction times.
The following are additional risk factors for the emergence of social anxiety disorder:
- female sex
- Social anxiety disorder in the family history
- timid disposition
- exhibiting as a child a severe dread of strangers and a retreat from unfamiliar circumstances.
What is the diagnosis process for social anxiety disorder?
Your physician can assist in differentiating social phobia from other anxiety disorders. He or she bases the diagnosis on a set of standards. An assessment for social anxiety disorder may be necessary if you:
- Possess a severe fear of being watched when eating or drinking, engaging in social activities (such as talking to someone, going to a party, or meeting new people), or giving a speech in front of an audience.
- Fear judgment, embarrassment, or humiliation from others
- Steer clear of social situations if you’re afraid or anxious.
- Feel that social anxiety interferes with both your personal and social life.
An accurate diagnosis of the illness requires the presence of these symptoms for a minimum of six months.
See your physician if you think you might have SAD. Appropriate diagnosis and treatment are crucial because individuals with SAD are more likely to experience depression and other mental health issues.
Options for Treatment
For social anxiety disorder, cognitive behavioral therapy and pharmaceutical medication are the two commonly used treatment modalities.
Cognitive behavioral therapy (CBT)
The primary treatment for SAD is psychotherapy in the form of cognitive behavioral therapy (CBT). Skilled experts assist you in identifying your triggers and developing coping mechanisms. CBT aims to teach you behavioral techniques to combat negative thoughts and to question your negative beliefs.
Both solo and group CBT sessions are possible. Most begin with a weekly session and then progressively cut back on how often they attend. It is advisable to attend two to four sessions annually once your symptoms are under control in order to avoid relapsing.
Medications
Your doctor may prescribe drugs that you can take either by themselves or in addition to CBT. The initial medications prescribed for social anxiety disorder are typically antidepressants. These drugs can help with anxiety symptoms even in non-depressed individuals. The two drug classes that prescribe antidepressants the most are:
- SSRIs, or selective serotonin reuptake inhibitors, include sertraline (Zoloft) and paroxetine (Paxil).
- Inhibitors of serotonin-norepinephrine reuptake (SNRIs), including venlafaxine (Effexor).
These drugs aid in restoring normal brain hormone levels, which are a contributing factor to SAD. You should start to feel some benefit even before you realize the entire impact of these medications on your symptoms, which could take up to three months of treatment.
Your doctor may recommend an anti-anxiety drug to treat your performance anxiety on an as-needed basis, such as right before a presentation. Among them are:
- benzodiazepines such as clonazepam (Klonopin) and lorazepam (Ativan).
- beta blockers such as propranolol (Inderal)
By lowering heart rate and soothing the neurological system, these drugs reduce anxiety temporarily and can be used as needed before to an anxious circumstance.
Supplementary tactics
Self-help methods can support other forms of therapy. A lot of these actions are simple to execute and might have advantages beyond boosting self-esteem.
- Practice mindfulness. The technique of being present without passing judgment is known as mindfulness. Being attentive is paying attention to your environment and feelings, but not acting on them. According to research, mindfulness can enhance both general quality of life and SAD symptoms.
- Address sleep issues. Research has indicated that individuals with social anxiety disorder are more likely to experience sleep issues. Anxiety is known to worsen when sleep deprived, and social avoidance may eventually rise as a result. To enhance the quality of your sleep, think about establishing a calming sleep schedule and limiting your time in front of a screen in the afternoon.
- Work out. Frequent exercise can lessen the symptoms of anxiety. Studies reveal that when paired with cognitive behavioral therapy, aerobic exercise might help reduce social anxiety even further.
- Limit or stay away from coffee and alcohol. Many people turn to drink to help them cope with their social anxiety, yet research has shown that alcohol actually makes anxiety worse over time. In a similar vein, caffeine, particularly at larger levels, can induce or exacerbate anxiety.
- Locate a support network. It is possible to legitimize your feelings and lessen social isolation by talking about your anxieties and listening to other people’s experiences. You may also improve your coping mechanisms by practicing vulnerability in a social context. A list of online and live support groups, including one specifically for those with social anxiety, is available from the Anxiety and Depression Association of America (ADAA).
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